Provider Demographics
NPI:1043866551
Name:SHELBOURNE, YANA (BSW)
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:SHELBOURNE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:YANA
Other - Middle Name:
Other - Last Name:GARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3304 E I 80 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-8781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3304 E I 80 SERVICE RD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-8781
Practice Address - Country:US
Practice Address - Phone:307-829-7355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker